Virginia Research Day 2025

Medical Student Research Public Health

05 Young Adult Location and Logistics Consideration and Rural Environments: The Y’ALL CARE Evaluation

Rebecca L. Wolf; Iva Skobic; Benjamin Pope; Hassan Chamas; Nishtha Sharma; Kayla Larsen; Angela Zhu; Hal Bright; Patricia Haynes Corresponding author: eakinade@vcom.edu

Edward Via College of Osteopathic Medicine Penn State College of Medicine

This study is a retrospective chart review of 1,591 patients aged 10-25 years. Seen for a medical evaluation for any medical appointment between July 1, 2021, and June 30, 2023, at a subspecialty adolescent medicine clinic with dedicated eating disorder and gender dysphoria service lines. Participants were determined to be rural based on address eligibility for rural-related healthcare services by the Centers for Medicare and Medicaid Services Rural Health Clinics Program or the Federal Office of Rural Health Policy grant programs. Other variables analyzed were the participant’s date of birth, age at

the time of appointment, legal sex, address at each appointment, race, ethnicity, type of insurance, and type of appointment (telemedicine or in-person). A logistic regression model evaluated the association between categorical demographic factors and telehealth use. A cluster-adjusted logistic regression model was applied to assess the significance of predictors on the use of telemedicine. The results of the regressions indicated that the participant's age (<.001), legal sex at the time of appointment (<.001), distance to the clinic (<.001), and rurality (0.011) were all significant contributors to the use of

telemedicine. Individuals living in rural areas were 1.4 (95% CI:1.09-1.90) times more likely to participate in the telemedicine session than those in non-rural areas. It becomes critical for policymakers to safeguard telemedicine to ensure equitable access to healthcare for rural populations post-COVID-19. However, there is a risk of disparate access to care based on insurance type without specific safeguards for telemedicine reimbursement. The study received approved by the Penn State College of Medicine, Protocol number 24073

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